ABSTRACT
even though surgery of cerebral hydatid disease has gone through many phases; the ultimate remains unchanged: the removal of the cyst intact so as to prevent recurrence. The purpose of this paper is to provide a surgical methodology to that end. a short review of the life cycle of echinococcus granulosus tapeworm is presented along with the pathology of hydatid cysts and their clinical presentation. We provide a step by step approach to the successful delivery of intracerebral hydatid cysts, stressing the caveat and pitfalls of such surgery. the patient's head on the operative table should remain free. The craniotomy should be a large one. All possible factors, which may lead to the rupture of the cyst, should be attended to [rough surfaces, sharp instruments, heat, etc.]. Rupture of the pericyst, episiotomies, Crede's manoeuvre and gravity are the four essential steps in the delivery of these cysts. Floatation of the cyst with saline can also be used. until a radical medicinal treatment for hydatid cysts of the brain is found, surgery should aim at delivering the cyst intact